Flashcards in 6.3. Rheumatology - Therapeutics Deck (13):
What are the 4 Categories of Treatment for Rheumatoid Arthritis?
What are the Medication Categories, for treating Rheumatoid Arthritis?
1. Non-Steroidal Anti-Inflammatory Drugs (NSAID's)
2. Disease Modifying Anti-Rheumatic Drugs (DMARD's)
What are Disease Modifying Anti-Rheumatic Drugs (DMARD's)?
A group of drugs which have been demonstrated to have slow-onset effect on disease activity, and retard disease progression
What is contained in Disease Modifying Anti-Rheumatic Drugs (DMARD's)?
How should you approach management of Rheumatoid Arthritis?
Early and Aggressive Intervention is Key
Why is Methotrexate used in the treatment of Rheumatoid Arthritis?
1. Its effective
2. It is well tolerated
3. It is cheap
Note - it is the cornerstone of combination treatment (with DMARD and Biologics)
What do Biologic DMARD's target?
Key aspects of the Inflammatory Cascade
What is the advantages / disadvantages of Biologic DMARD's, over traditional DMARD's?
1. They work rapidly
2. They are well tolerated
1. There are important toxicities (i.e. infection)
2. They come at a high cost
What Biologic DMARD's are available?
1. TNF-alpha Inhibitors
2. IL-1 Inhibitors
3. Anti B-Cell Therapies
4. Anti T-Cell Therapies
5. IL-6 Inhibitors
What are the issues with Biologic DMARD's?
1. Efficacy - Enhanced response when co-prescribed with Mtx
2. Toxicity - Injection site reaction / Infection / (Malignancy?)
3. Cost (£9500 vs £50)
By what method can Corticosteroids be administered?
2. I-A Injection
3. Intra-Muscular Injection
4. I.V. Infusion
What is taken into consideration whilst prescribing Corticosteroids for Rheumatoid Arthritis?
Short Term Benefit
Long Term Toxicity
Note - This is rarely appropriate as a single drug therapy